Siegel, Gordon J
Siegel, Gordon J is an individual health care provider with primary practice located at 3 E Huron St Fl 1, Chicago IL 60611-2887. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck, which is considered as his primary health care specialty. Siegel, Gordon J can be contacted via phone (312) 988-7777.Contact Information
Primary practice address
3 E Huron St Fl 1
Chicago IL 60611-2887
Phone: (312) 988-7777
Fax: (312) 988-7838
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck | 207YX0007X | 036053430 | Illinois |
Profile Details
NPI number | 1982609103 |
---|---|
LBN Legal business name | Siegel, Gordon J |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 15th, 2005 |
Last updated | Jan 31st, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1982609103 | NPPES |
Illinois | MEDICAID | 036059430 |
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